Post-Op Holiday Drinking & Alcohol After WLS – What’s The Surgeons’ View?

You can no longer metabolise alcohol in the same way

Alcohol absorption is highly variable and unpredictable after weight loss surgery. Before surgery, if you drank alcohol, the presence and digestion of food in the stomach would slow down its route into the small intestine and bloodstream. This would allow a gentler rate of absorption. 

When you have had gastric sleeve or gastric bypass surgery the size of your stomach is much smaller. It generally does not hold great volumes of food for digestion. Now that your stomach is reduced and able to hold less food, alcohol can pass at a faster rate. You also pass greater volumes into your small intestines, where it enters your bloodstream. (Hence, why most people find they get more intoxicated if they drink alcohol on an empty stomach).

Put simply, as a result of a smaller or bypassed stomach, you can potentially get drunk quicker than you used to. Also, your blood-alcohol levels remain higher for longer. A glass of wine may feel more like 2 or 3 with the new changes to your gastrointestinal anatomy and metabolism.

What impact could regular or high alcohol consumption have on my health?

Weight regain

Alcohol is basically sugar, and carbs with no nutritional value. Sugar is something you are trying very hard to eradicate as part of a bariatric diet. You are also on a reduced carb intake. So why would you drink them all back into your body again? Sugar and carbs in high doses will spike your blood sugar levels and can cause you to gain weight.

Poor food choices

On top of the sugar and carbs in the alcohol itself, you may be more likely to make poor food choices after you’re drinking. Let’s face it. When we drink, we often don’t reach for a salad. High or regular alcohol consumption could lead to choosing fatty, fried or sugary foods.  Drinking regularly, or too often can therefore be a slippery slope to weight regain.

Alcohol use disorder

Some people may be at an increased risk of developing alcohol use disorder (AUD). A recent study found that the AUD risk in gastric bypass (RYGB) patients could be as high as one in five people. There is no conclusive explanation as to why increased instances of AUD might occur. Certainly, higher alcohol levels in the bloodstream may be one cause. Some also suggest it has to do with addiction transference. This is where we replace an addiction to food with another, such as alcohol. With RYGB another possibility is to do with changes to the hormones which deal with reward circuits in the brain.

Alcohol-related health issues

Surgery is a tool which is designed to help you lose weight and increase your chances of a healthy and long life. But excessive alcohol consumption can really disrupt that chance. Liver damage, hypoglycemia, reflux, inflammation of the intestinal tract, and vitamin malabsorption are just a few of the resulting health concerns around alcohol in the weight loss surgery patient.

This is true also when we talk about alcohol. You may not see any impact to regular or high alcohol consumption at first, but long-term you will see its negative effects on your life. Alcohol is one of those things which we believe should be best left alone, if possible, for the first 12 months after surgery. Give yourself time to develop new habits around eating and socialising without adding alcohol to the mix.

After this time, you are still best to avoid alcohol, but the occasional social drink may be acceptable for some people. Just remember, you won’t be able to drink the same as you did before and will need to monitor this very carefully. At all times, it is important to check in with your alcohol consumption and keep an open dialogue with your surgeon or GP about your alcohol use.

If you are concerned about your alcohol use, now is the time to bring it up with your surgeon or GP, or to seek the help of specialist services in your area.